Tissue fastener and methods for using same

ABSTRACT

In one embodiment, a hook fastener has a plurality of hooks and a loop fastener has a plurality of loops to secure tissues sections to one another. At least one of these fasteners has a porous surface to allow tissue ingrowth to secure the fastener to the tissue. In another embodiment, only a single fastener is used, with a section of tissue being treated to engage and mate with the fastener. The disclosed tissue fastening systems can be used for a number of applications. One such example includes fastening tissue sections by wrapping a tissue fastener around the tissue and securing the fastener on itself. A suture may also be secured with the tissue fastener.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a division of, and claims the benefit of priorityto, copending U.S. patent application Ser. No. 10/427,151, filed Apr.30, 2003, the contents of which are hereby incorporated by reference intheir entirety.

FIELD OF THE INVENTION

The present invention relates generally to a tissue fastener and inparticular to a hook and loop type fastener with provisions to allowtissue ingrowth. The present invention also relates to a wide variety ofmethods of using the fastener for surgical and other interventionalprocedures.

BACKGROUND OF THE INVENTION

The vast majority of surgical procedures require suturing or otherwisecoupling first and second tissue sections. This coupling process can bedifficult to accurately perform and/or time consuming, particularly if alaparoscopic or other minimally invasive approach is used. Given thisneed, the prior art teaches a wide variety of fasteners. Although someof these fasteners have been specifically designed for medicalapplications, a number of fasteners were developed for non-medicalapplications and modified for biological uses.

One such fastener that can be used for different applications is theso-called hook and loop type fastener. Hook and loop fasteners havefound use in a wide variety of fields, including surgical procedures.For example, U.S. Pat. No. 5,906,617 to Meislin discloses surgicalrepair with a hook and loop type fastener. The '617 patent teaches firstand second sheets that are fixed to tissue with fibrin glue, eitheralone or in association with sutures and/or staples. Although this typeof fixation is suitable for initial and short term stability, the use ofsheets in combination with glue makes no provision for long termbiologic fixation, i.e. integration of the sheets with the tissue.Furthermore, the requirement of two glued sheets for all applicationsalso limits the utility to some surgical procedures.

U.S. Pat. No. 5,254,113 to Wilk discloses a method for use of a strip ofa biocompatible material in performing an anastomosis. The methoddisclosed includes juxtapositioning free ends of two sections of aresected tubular organ so as to form a continuous lumen through thesections, placing a strip of biocompatible material over the sections atthe seam and bonding the strip to the outer surfaces of the sections soas to form a seal about the sections at the seam. An inflatable balloonis used to maintain the sections in position and can be absorbed by thebody or excreted. The sections may also be stapled or sutured along theseam prior to the sealing of the strip over the seam, or the seam couldbe laser welded or sealed with a biocompatible adhesive. However, theuse of a balloon, laser welding, or other seals may be prohibited by thesize, location, or part of the body that may need to be sealed.

Thus, the need exists for an improved tissue fastening system.Additional features and advantages of the invention will be set forth inthe description that follows, and in part will be apparent from thedescription, or may be learned by practice of the invention. Theobjectives and other advantages of the invention will be realized andattained by the apparatus and process particularly pointed out in thewritten description and claims, as well as the appended drawings.

SUMMARY OF THE INVENTION

The invention is directed to a tissue fastening system, for couplingfirst and second tissue sections. The system includes a hook fastenerhaving a tissue contacting portion for contacting the first tissuesection and a fastening portion with a plurality of hooks, and a loopfastener having a tissue contacting portion for contacting the secondtissue section and a fastening portion with a plurality of loops,wherein the plurality of books engage the plurality of loops to couplethe first and second tissue sections and wherein at least a portion ofone of the hook fastener tissue contacting portion and the loop fastenertissue contacting portion has a porous surface allowing tissue ingrowthto thereby secure the fastener to tissue.

In another aspect, the invention is directed to a tissue fasteningsystem for coupling first and second tissue sections that includes atissue contacting portion for contacting the first tissue section, and afastening portion having at least one of a plurality of hooks and aplurality of loops, the fastening portion being integral with the tissuecontacting portion and wherein the at least one of the plurality ofhooks and plurality of loops engages the second tissue section tothereby couple the first and second tissue sections.

In yet another aspect of the invention, a method of coupling first andsecond tissue sections includes treating a portion of the first tissuesection to have a surface with one of a plurality of hooks and aplurality of loops, attaching a fastener to the second tissue section,the fastener having a fastening portion with the other of a plurality ofhooks and a plurality of loops, and placing the fastening portion incontact with the surface of the first tissue section to thereby couplethe first and second tissue sections.

In another aspect of the present invention, a tissue fastening method isdisclosed for coupling first and second tissue sections, the methodincludes bringing the first tissue section and the second tissue sectioninto contact with one another, wrapping a fastener around a portion ofthe first and second tissue sections, and securing the fastener onitself to maintain the first and second tissue sections in contact withone another, wherein, the fastener has a porous surface allowing tissueingrowth to thereby secure the fastener to the first and second tissuesections.

In another aspect of the invention, a tissue fastening system forcoupling first and second tissue sections is disclosed that includes asuture engaging the first and second tissue sections to maintain thefirst and second tissue sections in a predetermined relationship, a hookfastener having a plurality of hooks, and a loop fastener having aplurality of loops, wherein the plurality of hooks engage the pluralityof loops with a portion of the suture therebetween to thereby secure thesuture relative to the first and second tissue sections.

It should be understood that the present invention has a plurality ofdifferent features which may be utilized separately or in variouscombinations. It is also contemplated that the various features of theinvention may be utilized with known features from the prior art.Although specific combinations of features have been described herein,it is contemplated that other combinations of features will be apparentto those skilled in the art and will be formed.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features of the present invention will becomeapparent to one skilled in the art upon a consideration of the followingdescription of the invention with reference to the accompanyingdrawings, wherein:

FIG. 1 shows a schematic representation of a cross section of oneembodiment of a fastener according to the present invention in which thefastener has a plurality of hooks on a surface;

FIG. 2 shows a schematic representation of a cross section of oneembodiment of a fastener according to the present invention, in whichthe fastener has a plurality of loops on a surface;

FIG. 3 shows a top view of one embodiment of a tissue contacting surfacethat can be used with fasteners according to the present invention;

FIG. 4 shows a top view of another embodiment of another embodiment of atissue contacting surface that can be used with fasteners, according tothe present invention;

FIG. 5 shows a cross sectional view of the fastener of FIG. 1 in usewith the fastener of FIG. 2 to secure two tissue sections together;

FIG. 6 shows a top view of another embodiment of a tissue fasteningsystem that can be secured to itself according to the present invention;

FIG. 7 shows a bottom view of the tissue fastening system of FIG. 6;

FIG. 8 shows the tissue fastening system of FIGS. 6 and 7 as it isapplied to the tissue sections;

FIG. 9 shows a cross sectional view of the fastener of FIG. 1 in usewith the fastener of FIG. 2 to lock a suture therebetween; and

FIG. 10 shows a cross sectional view of the fastener to FIG. 1 in usewith the fastener of FIG. 2 to lock a suture therebetween as well as thetissue sections.

DETAILED DESCRIPTION OF THE INVENTION

For convenience, the same or equivalent elements in the variousembodiments of the invention illustrated in the drawings have beenidentified with the same reference numerals. Further, in the descriptionthat follows, any reference to either orientation or direction isintended primarily for the convenience of description and is notintended in any way to limit the scope of the present invention thereto.Finally, any reference to a particular biological application, such asuse for anastomosis applications, is simply used for convenience as oneexample of a possible use for the invention and is not intended to limitthe scope of the present invention thereto.

FIG. 1 shows a tissue fastener 50 according to the present invention.Fastener 50 includes a tissue contacting portion 52 and a fasteningportion 54. In use, tissue contacting portion 52 contacts the tissue andpreferably has a porous surface 56 having a plurality of interstitialspaces allowing tissue ingrowth by the tissue on which it is placed,thereby securing fastener 50 to the tissue. Porous surface 56 maycomprise all or only a portion of the tissue contacting portion 52 offastener 50. The porous surface 56 provide long term stability with thebiologic integration of fastener 50 to the tissue.

Fastening portion 54 has a plurality of hooks 58 on a surface. Hooks 58are similar to the hooks found on a hook and loop type fastener. Oneexample of such a hook and loop type fastener is commercially availableunder the trademark VELCRO®. In use, hooks 58 engage loops or othersimilarly textured surface so that fastener 50 is secured to whateverthe hooks 58 engage.

FIG. 2 shows a tissue fastener 60 that can be used with fastener 50 orby itself. Fastener 60 includes a tissue contacting portion 62 and afastening portion 64. In use, tissue contacting portion 62 contacts thetissue and has a porous surface 66 having a plurality of interstitialspaces allowing tissue ingrowth by the tissue on which it is placed,thereby securing fastener 60 to the tissue. As with fastener 50, all oronly a portion of the tissue contacting portion 62 may have the poroussurface 66. The porous surface 66 of tissue contacting portion 62provides long term stability with biologic integration of fastener 60 tothe tissue.

Fastening portion 64 is provided with a plurality of loops 68 on asurface. Loops 68 are similar to the loops found on a hook and loop typefastener (again, the most widely recognized example being commerciallyavailable under the trademark VELCRO®), but may be any structure thatallows for a hook-like structure to engage the loops 68. The loops 68may either be of the monofilament or multifilament type.

Fasteners 50 and 60 can be made of any biocompatible material. Althoughcommercially available hook and loop fasteners are generally not usefulin the present invention, the same techniques used in manufacturingcommercial hook and loop fasteners can be used to manufacture fastenersof this type of materials that are biocompatible. In one embodiment,fastener 50 (and/or fastener 60) is made from a non-biodegradablematerial and is intended to remain in the patient indefinitely. Thesematerial include metals and their alloys, polymers, ceramics, andcomposite material. For example DACRON® polyester is widely used assuture material and in implantable surgical devices. Polycarbonates arealso generally compatible with biological tissue. These and otherpolymeric materials can be formed into hook and loop fastener componentsusing standard manufacturing methods.

In another embodiment, at least a part of the fasteners 50,60 is made ofa biodegradable material that, with time, is absorbed and assimilated bythe body after the tissue regenerates. Suitable biodegradable materialsthat can be manufactured or formed as hook and loop fasteners includepolylactic acid, polycaprolactone, polyglycolic acid, polyanhydrides(e.g. polyterephthalic acid/sebaic acid anhydride, polydioxanone),polyamino acids (e.g. polyglycine, etc.), and copolymers of lactic acidwith comonomeric materials such as glycolic acid, hexamethyl sebacicacid, etc. These combine the qualities of non-immunogenicity,non-toxicity and an acceptable rate of bioabsorption versus regenerationof tissue.

Collagen and other polymers of biological origin (such as alginates,starch, etc.) are also suitable and can be treated to reduce theimmunogenic potential. Modified natural polymers such as gelatin,oxidized cellulose, etc., may also be utilized. Hydroxyapatite coral mayalso be used. In one embodiment, at least a portion (e.g. the tissuecontacting portion 52 and/or tissue contacting portion 62) of at leastone of the fasteners 50,60, is made using a scaffold material that caninclude viable cells. The scaffold material may be formed in manydifferent ways. Some of the different methods are disclosed inco-pending Provisional Patent Application No. 60/387,013, filed Jun. 7,2002 and entitled “Implanting Cells”, the contents of which areincorporated herein, by reference. One way in which the scaffold may beformed is by removing an organ or a portion of an organ from a body,either the patient's own body or another body. Cells and/or other tissuemay be removed from the organ or portion of an organ to leave a collagenmatrix support structure having a configuration corresponding to theconfiguration of the organ of portion of an organ. Viable cells arepositioned on the collagen matrix support structure. The scaffold, whichhas a configuration corresponding to the configuration of an organ orportion of an organ, is positioned in the patient's body with the viablecells disposed on the support structure.

It is contemplated that the scaffold may have a composite constructionand be formed of different materials which have differentcharacteristics. It is also contemplated that the viable cells may beany desired type of viable cells. The viable cells may correspond tocells which were in a damaged organ or other portion of a patient'sbody. More than one type of viable cell may be positioned on the samesupport structure. The support structure and viable cells may bepositioned in either hard or soft tissue.

Regardless of the material used to fabricate the fasteners, additivesmay be incorporated in the fasteners 50,60. Such additives may includematerials such as plasticizers, citrate esters, hexametholsebacate,antibiotics (e.g., tetracyclines, penicillins, mefronidazole,clindamycin, etc.), to prevent infection, etc., or to accomplish otherdesired conditions or results, including for example, tissue inductivegrowth factors to promote a growth of tissue between the porous surface66. Addition additives or therapeutic agents include osteoinductive,biocidal, or anti-infection substances. Suitable osteoinductivesubstances include, for example, growth factors. The growth factors maybe selected from the group of IGF (insulin-like growth factors), TGF(transforming growth factors), FGB (fibroblast growth factors), EGF(epidermal growth factors), BMP (bone morphogenic proteins), and PDGF(platelet-derived growth factors).

Further, these devices can be formed, in part, in situ, using fast lastdrying adhesives such as fibrin glue which attach the fastener to thebone or other tissue and also attach the hooks or loops to the bone ortissue. Another important feature of this invention is that sterile hookand loop material may be provided in larger sheets or rolls and cut atthe operating table into the exact size and shape needed to obtain thebest attachment.

As shown in FIGS. 3 and 4, porous surface 56,66 has a plurality ofinterstitial or void spaces 70 that are sized to aid tissue ingrowth. Asthe tissue grows into and through the void spaces, fastener 50 and/orfastener 60 becomes biologically bonded to the tissue. Such bondingprovides long term fixation superior to the long term fixationachievable with other means, such as suturing, stapling, gluing, and thelike. In FIG. 3, the void spaces 70 are defined by a mesh 72. As shown,mesh 72 is formed so that each of void spaces 70 is approximately equalin size. However, mesh 72 can be formed so that void spaces 70 vary insize. For example, the void spaces 70 may all have the same length (topto bottom in the figure), but have varying widths (side to side in thefigure), or vice versa. Also, the void spaces 70 may all have varyingsizes, however slight. Also, as shown in FIG. 4, void spaces 70 may alsobe formed by randomly oriented filaments, causing the void spaces 70 tovary in size. As is well known in the art, porous surfaces 56 and 66 canbe created by other means. For example, a porous beaded surface could beused for porous surfaces 56 and 66.

Regardless of their configuration and how they are formed, void spaces70 are preferably sized to provide optimal tissue ingrowth depending onthe tissue type. Typically, void spaces 70 range from around 0.1 micronsto 1000 microns. For bone tissue, suitable void spaces 70 range fromabout 8-10 microns or larger, preferably larger than about 20 micronsand less preferably of about 250 microns or larger. Tissue ingrowthresults in a stable implant of the fasteners 50 and 60, which s unlikelyto allow them to migrate from the site of original implantation.

While both fasteners 50 and 60 are illustrated as having a poroussurface, only one of fasteners 50 and 60 needs to be provided with aporous surface, if suitable for a particular application. One example ofa fastening system that utilizes both fasteners 50 and 60 will now bediscussed. However, as discuss below, fasteners 50 and 60 can be usedindependent of each other.

Fasteners 50 and 60, as illustrated in FIG. 5, can be placed on oppositesides of an opening 80 in tissue 82,84. Although fastener 50 is shown ontissue section 82 and fastener 60 is shown on tissue section 84, theymay be reversed. The fasteners 50,60 can be attached to the tissuesections 82,84 in a number of ways. For example, the fasteners may beattached simply by using surface tension of the two materials or byusing a biocompatible glue to secure the fasteners in place to allow thetissue ingrowth if desired. It should be noted that while tissuesections 82,84 are schematically illustrated in FIG. 5 to both be of thesame or similar tissue types, either or both may have a differentcomposition. For example, one of the tissue sections may be a bone andthe other tissue section may be a tendon associated with a muscle to bereattached to the bone. As illustrated in FIG. 5, the fasteners may alsohave an anchoring hole 86, through which an anchoring member 88, such assuture, a staple or rivet, may be inserted to hold the fasteners inplace. If, as noted above, the fasteners are biodegradable, then theanchoring member 88 can also be biodegradable so that it does not remainafter the fasteners resorb.

Once the fasteners 50,60 are in place on tissue sections 82,84, then thetissue sections are pushed in the direction of arrows 90 to allow thefastening portions 54,64 to engage one another to maintain the tissuesportions in a relative location with respect to one another.

Rather than using both fasteners 50,60, only one of the fasteners may beused. For example, if the fastener 50 is used and attached to tissuesection 82, the hooks 58 may directly engage the tissue section 84. Thefastener 50 may be attached to tissue section 82 in any manner discussedabove, i.e., fibrin glue, anchoring member, etc. Prior to pressing thetwo tissues sections together, the tissue section 84 may also first beprepared to receive the hooks 58 to allow for a better engagement of thefastener 50 with the tissue section 84. For example, the tissue sectionmay first be roughened with a rasp or other tool to provide the tissuesection 84 with a surface that engages the fastener 50. Using a rasp,the tissue surface is broken up sufficiently to allow the hooks 58 toengage the tissue section 84. Other methods of preparing the surface oftissue section 84 are also contemplated. For example, hooks may bedirectly attached the surface, i.e., providing several sutures or otherloops for the hooks 58 to engage.

Similarly, only the fastener 60 may be used with tissue section 84. Thefastener 60 may be attached to tissue section 84 in any method as notedabove. In order to allow the two tissue sections to be attached to oneanother, tissue section 82 may also be roughened with a rasp to providethe tissue with projections and elements on the tissue section 82 thatengage the loops 68 on fastener 60.

One example of an application in which only one of fasteners 50,60 needbe used is an anastomosis procedure, in which the ends of two vesselsare connected (see FIG. 8). In such a situation, the ends of the vesselswould be pre-treated as described above so that the ends engage eitherthe hooks or loops, depending on the fastener that is used.

FIGS. 6-8 shows another embodiment of a tissue fastener that can be usedto bring the ends of two tissues together. Fastener 90 has a tissuecontacting portion 92 and a fastening portion 94. The fastening portion94 is preferably at one end 95 of the fastener. This embodiment issimilar to those discussed above in that it is of the hook and loop typeand is made of biocompatible materials, and may even be made ofbiodegradable materials. Similarly, it may also have the mentionedadditives to assist in healing the tissues into which it comes intocontact. The tissue contacting portion 92 can have a porous surface 96that is similar to the porous surface 54, and also has a plurality ofinterstitial spaces allowing tissue ingrowth and thereby securingfastener 90 to tissue. The tissue contacting portion 92 may also have aplurality of loops 98 to engage a plurality of hooks 100 on thefastening portion 94. It should be noted that the arrangement of loopsand hooks can be reversed if desired.

As illustrated in FIG. 8, the fastener 90 is used to couple first 110and second 112 tissue sections to one another. The first tissue section110 and the second tissue section 112 are brought into contact with oneanother (or in close proximity) along surfaces 114 and 116,respectively. Fastener 90 is then wrapped around a portion of each ofthe tissue sections, with the fastening portion 94 on the endoverlapping the fastener 90 and engaging the tissue contacting portion92 to secure the fastener to the tissue. The amount of overlap of thefastener 90 will depend on the type and size of the tissues beingsecured to one another. Also, while the fastener 90 is illustrated ashaving a rectangular shape, it should be noted that the fastener 90could have any shape, including, for example, square, round, oval, orany other shape that would allow it to be used in the above describedmanner. Additionally, sterile hook and loop material can be cut not onlyto form the attachment per se but in lengths and/or widths to providereinforcement for weakened tissue or bone.

Additionally, FIG. 8 illustrates the use of a fastener 90 on two tubularstructures, but fastener 90 could also be used to bring the ends of twosolid, or even partially solid tissues, together. Fastener 90 may alsohave anchoring holes 118 for an additional means by which to secure thefastener 90 to the tissues. The anchoring member to be used with theanchoring holes 118 should be consistent with the use of the fastener90. As an alternative, or in conjunction with the anchoring member,fastener 90 can be heated to secure fastener 90 to the tissue. Theheating would be done at a temperature that minimizes tissue necrosis,yet still allows some flow of the material of fastener 90 so that a sealis created between the tissue and fastener.

Another use of a tissue fastener according to the present invention isillustrated in FIGS. 9 & 10. In one embodiment illustrated in FIG. 9,the fasteners 50 and 60 are used to secure the ends of a suture 120outside of the tissue sections. The suture 120 is used to secure twotissue sections 122,124 and the ends 126 of the suture 120 are thensecured between fasteners 50 and 60 rather than tied off, as usuallydone. As with the previous embodiments, the hooks and loops engage oneanother, but in this embodiment the ends of the suture are disposedtherebetween outside the tissue.

In FIG. 10, however, the fasteners 50 and 60 are at least partiallydisposed between the two tissue sections 130 and 132. The fasteners 50and 60 secure not only the tissue sections as noted above, but they alsosecure the ends 134 of the suture 136. In this embodiment, the suture istypically internal and the use of fasteners 50 and 60 allow fewersutures to be used since additional sutures are not needed to join thetissue sections 130 and 132 at the edge of the tissue. The fasteners 50and 60, and the suture 136, are preferably also made from abiocompatible material, and most preferably from a biodegradablematerial. It should also be noted that the loop portion of the fastener60 are preferably multifilament loops, to provide a stronger grip and toensure that the ends 134 of the suture 136 are appropriately captured.

While various descriptions of the present invention are described above,it should be understood that the various features could be used singlyor in any combination thereof. Therefore, this invention, is not to belimited to only the specifically exemplary embodiments depicted herein.

Further, it should be understood that variations and modificationswithin the spirit and scope of the invention might occur to thoseskilled in the art to which the invention pertains. Accordingly, allexpedient modifications readily attainable by one versed in the art fromthe disclosure set forth herein that are within the scope and spirit ofthe present invention are to be included as further embodiments of thepresent invention. The scope of the present invention is accordinglydefined as set forth in the appended claims.

What is claimed is:
 1. A method of coupling first and second tissuesections, including the steps of: bringing the first and second tissuesections into relative proximity; wrapping the proximate portions of thefirst and second tissue portions with a fastener including an elongateband substantially comprised of biodegradable material, the band having(a) pores, (b) a plurality of loops disposed upon a first side, and (c)a plurality of hooks extending from a second side, the hooks engageablewith the plurality of loops; overlapping a portion of the elongate bandcausing loops and hooks to become engaged, securing the elongate band inwrapped conformity with the first and second tissue sections, therebycausing the tissue sections to remain in relative proximity; wherebytissue ingrowth through the pores is enabled and the tissue sections maygrow together, whereafter the elongate band may biodegrade.
 2. Themethod of claim 1 further including the step of roughening a portion ofthe surface of at least one of the first and second tissue sections toenable the surface to be eagageable by hooks of the elongate band. 3.The method of claim 1, wherein the first and second tissue sections aretubular vessels, and wherein in said bringing step, the ends of thevessels are brought into relative proximity.
 4. The method of claim 1,further including the step of providing at least one hole in the bandfor further securing the band to the body.
 5. The method of claim 1,further including the step of using a biocompatible glue to furthersecure the elongated band and tissue sections.
 6. The method of claim 1,wherein in said step of wrapping, either the plurality of loops orplurality of hooks is provided only at an end portion of the elongateband.
 7. A tissue fastening method for coupling first and second tissuesections, the method comprising the steps of: bringing the first tissuesection and the second tissue section into contact with one another;wrapping a fastener around a portion of the first and second tissuesections; and securing the fastener on itself to maintain the first andsecond tissue sections in contact with one another, wherein the fastenerhas a porous surface allowing tissue ingrowth to thereby secure thefastener to the first and second tissue sections.
 8. The tissuefastening method of claim 7, wherein the fastener has a tissuecontacting portion for contacting the tissue sections and a fasteningportion, the fastening portion having a plurality of hooks and aplurality of loops, the plurality of hooks and loops engaging oneanother to secure the fastener on the tissue sections.
 9. The tissuefastening method of claim 7, wherein at least a portion of the fasteneris made of a biodegradable material.
 10. The tissue fastening method ofclaim 7, wherein at least a portion of the fastener includes anadditive.
 11. The tissue fastening method of claim 10, wherein theadditive has medicinal properties.
 12. The tissue fastening method ofclaim 7, wherein the fastener has at least one anchoring hole forreceiving an anchoring member to thereby secure the fastener to tissue.13. The tissue fastening method of claim 12, wherein the anchoringmember is selected from the group comprising a staple, a rivet, and asuture.
 14. A method of securing at least two sections of body tissuetogether, including the steps of: roughening an area of a first sectionof body tissue with a tool to create a broken tissue surface;positioning the roughened first section of body tissue with respect to asecond section of body tissue; connecting a fastener having a pluralityof hooks or loops on at least a portion of one side thereof to thesecond section of body tissue; pressing a portion of the fastener havinga plurality of hooks or loops over an area of roughened tissue tothereby engage the hooks or loops with the broken tissue surface. 15.The method of claim 14, wherein in said connecting step, the fastenerconnected further includes a plurality of pores to promote tissueingrowth.
 16. The method of claim 14, wherein in said connecting step,the broken surface forms projections and elements on the first sectionof body tissue which engage loops of the connected fastener.
 17. Themethod of claim 14, wherein in said connecting step, the fastener isconnected to said second section of body tissue with a member selectedfrom the group consisting of: glue, fibrin glue, suture, staple, rivet,mechanical fastener.
 18. The method of claim 14, wherein in saidconnecting step, the fastener is fabricated with a biodegradablematerial.
 19. A method disconnecting first and second tissue sections,including the steps of: roughening an area of the first and secondsections of body tissue with a tool to create broken tissue surfaces;bringing the first and second tissue sections into relative proximity;wrapping the proximate portions of the first and second tissue portionswith a fastener including an elongate band substantially comprised ofbiodegradable material the band having a plurality of hooks disposedupon a tissue contacting side; engaging roughened tissue with the hooks,thereby securing the elongate band in wrapped conformity with the firstand second tissue sections, thereby causing the tissue sections toremain in relative proximity, whereafter the first and second tissuesections may grow together, and the elongate band may biodegrade. 20.The method of claim 19, wherein in said step of wrapping, the fastenerincludes a plurality of pores to promote tissue ingrowth.